Implementation of health insurance navigation for racial/ethnic minority men who have sex with men presenting for community-based HIV testing

Objective: Being uninsured is a barrier to accessing HIV prevention and treatment. This study assesses the implementation of health insurance navigation. Design: Randomized structural intervention conducted from 2018-2020 in Chicago, Illinois. Black/African American and Hispanic/Latino men who have sex with men (MSM) presenting for community-based HIV testing (N=230) were offered a single session of health insurance navigation immediately after their HIV test, regardless of HIV test result. Methods: Using descriptive statistics, we present socio-demographic characteristics, health insurance navigation uptake, and immediate health insurance outcomes resulting from navigation. Results: Most participants were 18 to 34 years of age (n=175, 76.0%), most identified as non-Hispanic Black/African American (n=202, 87.8%), and most were insured (n=164, 71.3%). Half (n=115, 50.0%) accepted navigation. Of those 115, 10 uninsured participants enrolled in health insurance (8.7%) and 21 began the enrollment process (18.3%); 80 insured participants reviewed their current plan (69.6%), and four changed to a plan better suited to their HIV care needs (3.5%). Almost all 115 were satisfied with the amount of time they had with the navigator (n=114, 99.1%) and the services they received (n=107, 93.0%). Conclusion: Health insurance navigation provided at the time of HIV testing was an acceptable and feasible method to engage Black/African American and Hispanic/Latino MSM in health insurance education and enrollment. Community-based structural interventions, such as health insurance navigation delivered in tandem with HIV testing, can be used to address health insurance enrollment disparities and to meet national public health and Ending the HIV Epidemic (EHE) goals.